Glen Flora Dental
Dentist, General Practice in Waukegan, IL. Organization (NPI-2).
NPI number1063592467
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1063592467
- Entity type
- Organization (NPI-2)
- Legal business name
- Glen Flora Dental
- Organization subpart
- No
- Enumeration date
- Oct 17, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
1020 W Glen Flora AveWaukegan, IL 60085-1882
Phone 847-623-0399 · Fax 847-623-4745
Mailing address
1020 W Glen Flora AveWaukegan, IL 60085-1882
Phone 847-623-0399 · Fax 847-623-4745
Authorized official
Brandi Skinner
Office Manager
8476230399
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